This four year study will compare patterns of informal support networks among older urban, rural and reservation based American Indians; 2)examine the influence of the informal social network on the long-term care sought and obtained by older Native Americans and 3) examine determinants, including culturally related attitudes, preferences and structural factors that enable or inhibit utilization of both informal and formal long-term care among American Indians. The research will involve American Indians in Michigan. Research about urban and rural non-reservation American Indians, as well as tribes living east of the Mississippi, has been limited. Building on recent needs assessment and health risk projects, the research will interview 120 older Native Americans living in urban communities, 120 from rural areas, and 120 from reservations. Each respondent will be interviewed twice, with the interviews separated by an 18 month interval. These two interviews will allow the assessment of changes in the informal social network, long-term care assistance from network members and formal assistance to meet long-term care needs. Open ended probes will be used extensively in the interviews to understand the expectations of respondents about formal and informal long-term care. In addition, focus groups will be held after completion of the interviews and preliminary analysis of the data. Two focus groups will be held with older American Indians from urban communities, two with rural and two with reservation-based older American Indians. Two focus groups will also be held with, American Indian tribal leaders. The focus groups will provide an opportunity to explore and probe with older American Indians the results of the surveys. The focus groups with Michigan's tribal leaders will also provide an opportunity to discuss possible future changes in informal social networks,attitudes among older Native Americans in urban, rural and reservation areas and the impact of these changes on long-term care issues.